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Exercise and cardiometabolic health: ‘Never too late to start exercising’

December 5, 2019

LOS ANGELES — Exercise provides important and varied benefits for individuals with cardiometabolic disorders regardless of experience level, and certain exercise types may yield better outcomes for those with certain conditions, according to a speaker at the World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease.

“It’s never too late to start exercising to have a significant profit from it,” Nikolaos Perakakis, MD, PhD, instructor in medicine in the endocrine division at Beth Israel Deaconess Medical Center and Harvard Medical School, said during a presentation.

Myriad benefits of exercise

Previous research has demonstrated that risk for all-cause mortality, cancer mortality and CV mortality can be cut by 40% to 60% by incorporating a daily routine of 30 minutes of physical activity, he said.

With metabolic syndrome, regular exercise has been shown to reduce individual components, including waist circumference, triglycerides, blood pressure and fasting glucose. In a recent systematic review and meta-analysis published in Metabolism, van Namen and colleagues reported that a supervised lifestyle intervention incorporating regular exercise and diet change reduced the prevalence of metabolic syndrome by 39%. Perakakis said aerobic exercise alone appears to yield the most benefit for patients with metabolic syndrome.

“Aerobic exercise actually [is] as effective or even more effective than combined aerobic and resistance exercise in patients with metabolic syndrome,” Perakakis said.

For patients with type 1 and type 2 diabetes, benefits such as improved glycemic control and less insulin resistance are attainable via increased physical activity, particularly aerobic exercise.

 

Type of exercise also plays a role for patients with nonalcoholic fatty liver disease, Perakakis said.

“In contrast to what we see in type 2 diabetes, in nonalcoholic fatty liver disease, anaerobic exercise seems to be much more beneficial,” Perakakis said, noting that anaerobic or resistance exercise “shows more robust decrease[s] in intrahepatic lipid percentage compared with aerobic exercise.”

The reasons underlying the differences by type of exercise are unclear, he said.

“We don’t have a clear explanation for this from a pathophysiological point of view. We think, though, that ... aerobic exercise is focusing more on lipolysis or is acting more on adipose tissue ... whereas resistance exercise is acting more directly on the liver,” Perakakis said.